[Unstable atherosclerotic plaque and acute coronary syndromes].
Acute coronary syndromes (unstable angina pectoris, acute myocardial infarction, sudden cardiac death) participate significantly in cardiovascular and general morbidities and mortalities. Their common pathogenetic mechanism resides in the disturbance of the integrity of atherosclerotic plaque by a fissure, rupture, or ulceration and the origin of unstable atherosclerotic plaque by the formation of thrombi, which together with vasoconstriction, causes a varying degree of the dynamic obstruction of the coronary artery. Thrombogenesis takes place in coincidence with the factors of vascular wall, rheologic, thrombotic (proaggregatory and procoagulatory), and antithrombotic (antiaggregatory and anticoagulatory-fibrinolytic) factors. The formation of unstable atherosclerotic plaque is a critical point of the dissociation of both stable and unstable myocardial ischaemiae. The prevention and therapy of atherosclerosis must be complex, namely antiatherogenic, however most of all endothelium-protective, or cellulo-protective, antilipidogenic and antithrombogenic. They cannot be alternative; one therapy will not substitute another. Regarding the importance of even residual thrombosis and thrombin, new antithrombotic substances are being intensively investigated.
Gavorník
P
P
II. interná klinika Lekárskej fakulty Univerzity Komenského v Bratislave, Slovakia.
D000208:Acute Disease; D000789:Angina, Unstable / Q000209:etiology* / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000150:complications* / Q000503:physiopathology*; D003328:Coronary Thrombosis / Q000209:etiology / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology* / Q000503:physiopathology
Nestabilný aterosklerotický plát a akútne koronárne syndrómy.